Allergic diseases are very common and include allergic rhinitis (hay fever), atopic dermatitis (eczema), urticaria (hives), chronic sinusitis (infections), asthma, food allergies, drug allergies, insect allergies, and anaphylaxis (life-threatening allergic reactions). If people knew what they were allergic to, and took proper preventative measures, they would not have nearly the amount of suffering or medication use. Here are ideas to help people understand how they can live healthier lives.

Thursday, July 29, 2010

Dulera is a combination product of an inhaled corticosteroid (mometasone furoate, which is the same as Asmanex) and a long-acting bronchodilating agent (LABA) for asthma. I've written about this earlier. The FDA approved Merck's Dulera on June 24, 2010. Here is the FDA's medication guide. Dulera became the third combined product available, following Advair and Symbicort. I was privileged to assist with the trials to approve Dulera. I personally noted no problems, but much more importantly, the FDA did not find particular problems with Dulera. I think it will compete in the market place with other asthma products as simply another option to treat asthma. Note the LABA (formoterol) in Dulera is the same as in Symbicort, Foradil, Perforomist, and Brovanna. There are no comparative trials available nor planned to my knowledge.

Congratulations to Merck and asthmatics,

from your Allergy Dude

addendum: 8/12/10. Samples were delivered to my office. This is the only sky blue inhaler available (see photo). There is a counter on the back side to measure the number of puffs produced from the inhaler. The only difference between the two strengths, 100 versus 200, is the barely visible yellow label and light purple label respectively on the top of the canister. Being environmentally conscious, I am happy to report that the propellant is HFA. Each canister contains enough medication for 120 puffs. Cost is unknown. Insurance coverage is likely to be non-existent, because it typically takes about 1 year for a new medication to get on an insurance company's drug formulary and being covered at an acceptable level. Due to my sensitivity for my patient's spending on medications, not discomfort with Dulera itself, I predict that some time will occur before I am commonly prescribing Dulera for properly indicated patients.Your Allergy Dude

addendum: 8/20/10. Some physicians offices may have coupons for Dulera. The initial offer is for 1 free month's supply, meaning 1 cannister. Both doses are being priced the same, with an AWP of $188. The cash price at the pharmacy will be about $200 then.Your Allergy Dude

1 comment:

HFA's make my and a lot of asthmatics asthma worse! CFC's from inhalers contributed to a miniscule proportion of the total emissions compared to other sources and their removal is putting people who depended on them at risk. See: http://www.consumeraffairs.com/health/hfa_inhalers.html for more information.

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My biography and contact me

I am a board certified specialist in internal medicine as well as allergy and immunology. I practice in Greenville and Spartanburg, South Carolina.
I attended the University of Chicago as an undergraduate—although this was before Barack Obama taught there!—and earned my B.A. in Chemistry in 1984. I earned my M.D. at the University of Illinois Medical School. Then, I did a three-year residency in internal medicine at Lutheran General Hospital. Finally, my two-year fellowship in allergy and immunology was at Rush Medical College.
This blog is dedicated to my wife and four kids. My motto (courtesy of my wonderful wife) is, "If you sneeze or wheeze, come see me, please." She is the reason I went into allergy. She has severe allergies, and I wanted to learn about how to take better care of her health. The service organizations I support are the American Lung Association and Boy Scouts of America.
The purpose of this blog is to help people understand and manage allergic diseases. This blog is the direct result of patients asking me questions. I am always trying to improve, so if you notice an error, please contact me.

Quotes for the day

"When I was young, my ambition was to be one of those people who made a difference in this world. My hope still is to leave the world a little bit better place for my having been here. It's a wonderful life and I love it."Jim Henson

"Life is very short, and very uncertain; let us spend it as well as we can."Samuel Johnson

MY GOALS AT PATIENT EVALUATIONS

1. Figure out what is going on. What's the name of the disease process? What's the cause(s)? Ask questions, examine, order diagnostic tests.2. Make me better, yes, at the price of taking more medications initially.3. Keep me better, preferably on as little medication as possible, for the long-term. Some medications may be necessary to prevent attacks.